Innovative solutions in the personal home care space increasingly feature bundled services for payers and providers, according to Chiara Bell, founder and CEO of Care Heroes, who presented an overview of offerings at Tellus’ second annual EVV national forum last month.
Bell launched her company after working in the senior care space, focusing on post-acute, home health and Managed Medicaid markets where she saw a lack of attention and respect for caregivers: “Nobody was looking at this workforce as an asset. The really important outcomes in non-clinical care is equally important as acute care, and in many instances, more important.”
She started Care Heroes with a mission founded on the belief that people in the home who are touching her patients “are vital to the care team so we should pull them in and connect them to the wider system of payers and state agencies.”
Care Heroes creates a direct connection between health plans and caregivers, allowing members to stay at home while keeping health plan costs in check, according to its Web site. This is done with technology and bundled services that harness outcomes and analytics, service plan validation and quality assurance — all while rewarding quality caregivers with starred-ratings.
The problem we’ve been focused on solving is gaining insight into the quality of the provider network or caregiver services like developing effective measurement tools to determine how excessive work shifts may be impacting patient outcomes. Data that’s driving provider reimbursement is key, she said.
“We think EVV is a very, very important step,” she said.
Care Heroes’ recent partnership with Tellus allows it to share data that’s coming in with the right people at the right time to leverage information and care management in a very different way, specifically for Medicaid plans, she added.
So, how do we get to a solution that is going to be valuable in the field for payers and providers while supporting the new model of value-based incentives and quality bench-marking being pushed by CMS? Bell asked.
The company did things a little differently in the beginning, she said. “We said let’s partner with the health plan, start getting the data from them, and then pushing important data back to their contracted providers.”
Care Heroes partners with the health plan and EVV vendors to build value-based program models, she noted.
All of the information from one health plan she interfaced with for a year and a half had never been shared in such a comprehensive format back to the contracted providers she was working with, she said. With Care Heroes they can see what the care manager did in their original assessment identifying member goals, and what other services were approved and delivered to that member. Then connecting the care manager who’s assigned more directly to track that member’s care.
In many states, providers spend a lot of time trying to reach that person, she said, noting that with Care Heroes it has become easier to see the services provided, to see the assessments, and see all the EVV data in one place with a simple communication tool to track and manage that member’s care.
Bell said she has learned a lot by working side-by-side with providers and MCOs. The company’s approach to technology design and implementation is based on one of those key learnings: many providers have EVV solutions, but want to use Care Heroes because they can see all of this data they never had access to, simplifying nursing assessments or connecting more easily with a care manager.
Part of that component is being able to pull in the care activity being completed by the EVV system or caregiver in the home, she added. The core function is simple communication and simple reporting back in a much more secure, cloud-based environment between the MCO, provider and ultimately caregivers in the home.
Care management is another, very different component, she said.
“As you look at seeing EVV being just focused on check in and check out, as it continues to expand, you are able to report critical incidents and critical data not just back to the state but sent in real time to care management.”